Robotic system for tele-surgery

ABSTRACT

Disclosed herein is a robotic tele-surgery system for performing laparoscopic surgeries. The system may include: a patient-side unit, a surgeon-side unit, and a controller that may be configured for establishing a master-slave relationship between the surgeon-side unit and the patient-side unit. The patient side unit may include a patient support assembly, at least two passive mounting mechanisms that may be slidably coupled to the patient support assembly and at least two slave robotic arms, coupled with a surgical instrument via a tool adapting mechanism from their distal end, and mounted on an associated passive support assembly from their base end. The surgeon-side unit may including at least two master robotic arms, and an ergonomic adjustment mechanism that may be configured for housing and adjusting the position and orientation of the master robotic arms.

CROSS REFERENCE TO RELATED APPLICATION

This application claims the benefit of priority from pending U.S. Provisional Patent Application No. 62/258,584, filed on Nov. 23, 2015, and entitled “A MODULAR ROBOTIC SYSTEM WITH FORCE FEEDBACK FOR REMOTE LAPAROSCOPIC SURGERY,” which is incorporated herein by reference in its entirety.

TECHNICAL FIELD

The present disclosure generally relates to surgical robotic systems, particularly to a robotic system for remote surgery, and more particularly to a modular robotic system with force feedback for remote laparoscopic surgery.

BACKGROUND

Minimally invasive surgery (MIS) is increasingly recognized as an effective alternative to traditional open surgery. MIS operations on the internal abdomen organs are performed as laparoscopic surgery, in which, a miniature video camera and long narrow surgical instruments are inserted into the abdomen cavity through small incisions. The camera provides an image of the interior of the abdomen, enabling the surgeon to explore the internal organs and perform the operation using the surgical instruments.

Laparoscopic surgery has advantages over open surgery. It causes less operative trauma and post-surgical complications that shorten the hospitalization time and associated costs. Also, it leads to a much faster recovery for a patient, which is of great physiological and psychological importance. However, it is technically more demanding and at the same time more tedious and difficult for the surgeon. Laparoscopic surgery usually takes longer and needs more concentration than an open surgery. In particular, during operation, surgeons hold postures that are more static and non-ergonomic compared to that of open surgery, likely caused by less efficient instruments. Static postures have been reported to impose more fatigue than dynamic ones because the muscles and tendons form lactic acid and toxins when held in static position. Moreover, the non-ergonomic postures may expose surgeons to physical discomfort that may reduce the surgeons' precision, dexterity and confidence during surgery.

With the advancements of the robotic surgery systems, the surgeons are now able to carry out MIS procedures remotely, in more ergonomic postures. Moreover, the rigid mechanical structure of robot, along with the more efficient high degree of freedom (DOF) surgical tools, allows for improved maneuverability and a more precise and stable surgery with less tremor. Such characteristics of the surgical robots have enabled successful surgeries for prostate cancer, bladder cancer, renal pelvis cancer, colon cancer, and the like.

A robotic surgery system consists of a master manipulator and a slave robot. As the surgeon operates the master manipulator, it generates and transmits control signals to the slave robot. Accordingly, the slave robot operates and performs surgery on the patient based on the received signals. The currently available robotic surgery systems are based on integrated complex designs that require sophisticated infrastructure and educated human resources for maintenance and technical support. As a result, they are much expensive and involve very high maintenance costs. Moreover, the currently available systems utilize integrated and exclusively designed surgical tools at their end effector that are of single or limited use. Again, this increases their maintenance and operating costs considerably. Finally, the currently available systems do not provide force feedback information that is essential for avoiding excessive pinch or pull forces that could be damaging for the tissues under surgery.

In light of the above, it would be desirable to provide alternative designs and methodologies for robotic tele-surgery systems that improve the efficiency, flexibility, and comfort during surgery and reduce the price and operating and maintenance costs of the system. It would be particularly desirable to utilize modular designs that provide more configuration flexibility and the possibility of using conventional hand-held surgical tools. It would be further desirable to provide methods and techniques for measuring the tool-tissue force interactions to avoid large injurious forces on the tissues.

SUMMARY

The following brief summary is not intended to include all features and aspects of the present application, nor does it imply that the application must include all features and aspects discussed in this summary.

The instant application discloses various systems and apparatuses directed to robotic tele-surgery. Various exemplary apparatuses are disclosed, and examples may include a robotic tele-surgery system for performing laparoscopic surgeries. The system may include a patient-side unit, a surgeon-side unit, and a controller that may be configured for establishing a master-slave relationship between the surgeon-side unit and the patient-side unit. In an aspect, the patient side unit may include a patient support assembly, at least two passive mounting mechanisms that may be slidably coupled to the patient support assembly and at least two slave robotic arms, coupled with a surgical instrument via a tool adapting mechanism from their distal end, and mounted on an associated passive support assembly from their base end. In an aspect, the surgeon-side unit may include at least two master robotic arms, and an ergonomic adjustment mechanism that may be configured for housing and adjusting the position and orientation of the master robotic arms.

In an aspect, each passive mounting mechanism may have five degrees of freedom that may include a first linear axis, a second linear axis, a third linear axis, a pan axis, and a tilt axis. Each passive mounting mechanism may include: a first sliding segment that may be slidably coupled to the patient support assembly and may allow the passive mounting mechanism to be moved along the first linear axis parallel to the upper surface of the patient support assembly; a second sliding segment that may be slidably coupled to the first sliding segment and may be movable along the second linear axis; a third sliding segment that may be slidably coupled to the second sliding segment and may be movable along the third linear axis; and a pan/tilt mounting mechanism that may be configured to be attached to the base end of the slave robotic arm and to facilitate movement of the slave robotic arm about the pan axis and about the tilt axis. The pan/tilt mounting mechanism may be attached to the third sliding segment. The first, second, and third linear axes may be mutually perpendicular.

In an aspect, each slave robotic arm may have three degrees of freedom comprising a first rotational axis, a second rotational axis, and a linear translational axis. Each slave robotic arm may include: a first arm segment that has a proximal end and a distal end; a first rotational actuating mechanism that may be coupled to a proximal end of the first arm segment, and may be configured to drive a roll-rotation movement of the first arm segment about the first rotational axis; a second arm segment that has a proximal end and a distal end; a second rotational mechanism that may be attached to the distal end of the first arm segment, and coupled to a proximal end of the second arm segment. The second rotational mechanism may be configured to drive a roll-rotation movement of the second arm segment about the second rotational axis; a passive linear actuating mechanism that may include a passive wagon and a passive track. The passive wagon may be mounted on the distal end of the second arm segment, and it may be configured to be movable on the passive track along the linear translational axis; and an active linear actuating mechanism that may include a linear actuator, an active track attached to the passive track, a moving wagon mounted on the active track, and a tool attachment interface mounted on the moving wagon. The active linear actuating mechanism may be configured to drive a linear translational movement of the sliding wagon along the linear translational axis.

According to an implementation, the first rotational mechanism may include a first motor, and a first gear box coupled to the proximal end of the first arm segment. The first motor and the first gear box may be configured to drive the roll-rotation movement of the first arm segment about the first rotational axis.

According to an implementation, the second rotational mechanism may include a second motor, and a second gear box coupled to the proximal end of the second arm segment. The second motor and the second gear box may be configured to drive the roll-rotation movement of the second arm segment about the second rotational axis.

According to an implementation, the tool adapting mechanism may be a servo-mechanical interface, which may be configured for manipulating an end effector of the surgical instrument.

In an aspect, the ergonomic adjustment mechanism may have three degrees of freedom, including a substantially vertical axis, a substantially horizontal axis, and a rotational axis. The ergonomic adjustment mechanism may include: a main frame; a vertical adjustment mechanism that may be movable along the vertical axis, and may be mounted on the main frame; a horizontal adjustment mechanism that may be rotatably mounted on the vertical adjustment mechanism, and it may include at least two mounting platforms attached thereto, configured for mounting the master robotic arms. The horizontal adjustment mechanism may be rotatable about the rotational axis, and the master robotic arms may be slidably mounted on the mounting platforms and may be movable along the horizontal axis.

In an aspect, each master robotic arm may have six degrees of freedom, including a pitch axis, a yaw axis, a roll axis, insert, grasp, and a local roll axis. Each master robotic arm may include: a master handle having a stationary handle, a movable handle, a roll-knob, and a central rail, that may be configured to be manipulated by a surgeon's hand; a pitch sensing/actuating mechanism coupled to the central rail of the master handle that may be configured to sense pitch-rotational movement of the master handle about the pitch axis, and may be further configured to actuate a pitch-rotational movement in the master handle corresponding to a pitch-rotational movement in the surgical instrument in the patient-side unit; a yaw sensing/actuating mechanism coupled to the central rail of the master handle that may be configured to sense yaw-rotational movement of the master handle about the yaw axis, and may be further configured to actuate a yaw-rotational movement in the master handle corresponding to a yaw-rotational movement in the surgical instrument in the patient-side unit; a roll sensing/actuating mechanism coupled to the central rail of the master handle that may be configured to sense roll-rotational movement of the central rail about the roll axis, and may be further configured to actuate a roll-rotational movement in the central rail corresponding to a roll-rotational movement in the surgical instrument in the patient-side unit; a finger-roll sensing/actuating mechanism coupled to the roll-knob of the master handle that may be configured to sense roll-rotational movement of the roll-knob about the local-roll axis, and may be further configured to actuate a local roll-rotational movement in the roll-knob corresponding to a local roll-rotational movement in the surgical instrument in the patient-side unit; a grasp sensing/actuating mechanism coupled to the movable handle of the master handle that may be configured to sense grasp movement of the movable handle, and may be further configured to actuate a grasp movement in the movable handle corresponding to a grasp movement in the surgical instrument in the patient-side unit; and an insert sensing/actuating mechanism coupled to the central rail of the master handle that may be configured to sense insert movement of the master handle along the insert degree of freedom, and may be further configured to actuate an insert movement in the master handle corresponding to an insert movement in the surgical instrument in the patient-side unit.

According to an implementation, the surgical instrument may be selected from non-articulating laparoscopic instruments, handled wrist-articulating instruments, or handle-free wrist articulating instruments. The degrees of freedom of the surgical instrument include grasp, roll, pitch, and yaw.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims particularly pointing out and distinctly claiming the subject matter that is regarded as forming the present application, it is believed that the application will be better understood from the following description taken in conjunction with the accompanying DRAWINGS, where like reference numerals designate like structural and other elements, in which:

FIG. 1A illustrates a top view of one example implementation of a robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 1B illustrates an example configuration of arm assemblies with two arms, pursuant to one aspect of the present disclosure.

FIG. 1C illustrates an example configuration of arm assemblies with three arms, pursuant to one aspect of the present disclosure.

FIG. 1D illustrates an example configuration of arm assemblies with four arms, pursuant to one aspect of the present disclosure.

FIG. 2A illustrates one implementation of an example patient-side unit for one robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 2B illustrates one implementation of an example patient-side unit without protective covers, according to one or more aspects of the present disclosure.

FIG. 2C is an assembled view of one implementation of an example passive mounting mechanism, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 2D is a left view of one implementation of an example passive mounting mechanism, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 2E illustrates an exploded view of one implementation of an example passive mounting mechanism, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 2F illustrates an exploded view of one implementation of an example pan/tilt mounting mechanism, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 2G illustrates one implementation of an example first sliding segment, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 2H is an assembled view of one implementation of an example passive mounting mechanism with support structures, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 2I is an assembled view of one implementation of an example passive mounting mechanism with support structures for controller components and motor drivers, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 3A is an assembled view of one implementation of an example slave robotic arm, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 3B illustrates an exploded view of one implementation of an example slave robotic arm, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 3C illustrates a left view of one implementation of an example slave robotic arm, for a robotic tele-surgery system according to one or more aspects of the present disclosure.

FIG. 4A illustrates one implementation of an example surgeon-side unit for one robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 4B illustrates a partial view of one implementation of an example ergonomic adjustment mechanism for the surgeon-side unit of one robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 4C illustrates a partial view of one implementation of an example ergonomic adjustment mechanism for the surgeon-side unit of one robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 4D illustrates one implementation of an example master robotic arm for one robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 4E illustrates one implementation of an example master robotic arm without the mounting platform for one robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 4F illustrates one implementation of an example master handle of a master robotic arm for one robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 4G illustrates a top portion of one implementation of an example master handle of a master robotic arm for one robotic tele-surgery system, according to one or more aspects of the present disclosure.

FIG. 5 illustrates an exemplary scenario for aligning a fixed point (i.e., remote center of motion) of the robotic arms with the incision location on patient's body utilizing the passive mounting mechanism, consistent with exemplary embodiments of the present disclosure.

DETAILED DESCRIPTION

In the following detailed description, numerous specific details are set forth by way of examples in order to provide a thorough understanding of the relevant teachings. However, it should be apparent that the present teachings may be practiced without such details. In other instances, well known methods, procedures, components, and/or circuitry have been described at a relatively high-level, without detail, in order to avoid unnecessarily obscuring aspects of the present teachings.

For purposes of explanation, specific nomenclature is set forth to provide a thorough understanding of exemplary embodiment of the present disclosure. However, it will be apparent to those skilled in the art that these specific details are not required to practice exemplary embodiments of the present disclosure. Descriptions of specific applications are provided only as representative examples. Various modifications to the exemplary implementations may be readily apparent to one skilled in the art, and the general principles defined herein may be applied to other implementations and applications without departing from the principles of the exemplar embodiment of the present disclosure. Practices according to concepts disclosed by the present disclosure are not intended to be limited to the implementations shown, are to be accorded the widest possible scope consistent with the principles and features disclosed herein.

Disclosed exemplary systems and methods directed to laparoscopic tele-surgery may include a modular robotic tele-surgery system comprising a surgeon-side unit and a patient-side unit. The surgeon-side unit may include different assemblies to enable a user (i.e., a surgeon) to perform a tele-surgery. The hand movements of the surgeon may be captured in the surgeon-side unit and they may be reconstructed in the patient-side unit to enable the surgeon to remotely perform a laparoscopic surgery. Moreover, the force and torque exerted on the surgical tools at the surgery site may be sent to the surgeon-side unit as a haptic feedback to the hands of the surgeon. The patient-side unit may include slave robotic arms that may be mounted and adjusted on a patient support assembly using passive mounting mechanisms. The orientation of the patient during surgery may be adjusted by the patient support assembly and the fixed point of the robotic arms may be aligned with the incision location utilizing the passive mounting mechanisms that are mounted on the patient support assembly. Benefits of these features may include, but are not limited to, maintaining the alignment between the fixed point of the slave robotic arms and the incision location during surgery, and enabling changes in the patient's orientation during surgery without the need for removing surgical instruments from the patient's body. Moreover, the surgeon-side unit may include adjustment mechanisms that enable the surgeon to perform the surgery in an ergonomic comfortable posture, in either a sitting position or a standing position.

FIG. 1A is a top view of one example robotic tele-surgery system 100 in accordance with one or more aspects of the present disclosure. The robotic tele-surgery system 100 may include a surgeon-side unit 101 and a patient-side unit 102 that may be in a master-slave relationship with one another, which will be described in detail later in the present disclosure.

Referring to FIG. 1A, the robotic tele-surgery system 100 may be configured for performing minimally invasive surgeries. The system 100 may be used to perform a surgical procedure on a patient 103 that is typically lying on a patient support assembly (e.g., operating table, etc.) 104. Mounted to the patient support assembly 104 is a first arm assembly 105, and a second arm assembly 106. The arm assemblies 105 and 106 may be mounted to the table so that the arms 105 and 106 are in a plane proximate to patient 103 and movable with patient support assembly 105. Moreover, arms 105 and 106 may be slidably mounted on track assemblies 107 a and 107 b on either sides of the patient support assembly 104 and they may be configured to be slidably movable along the sides of the patient support assembly 104. The system may include an endoscope/camera assembly 108 that may be configured to hold and position an endoscope/camera 109.

The first and second arm assemblies 105 and 106 each may be configured with a passive mounting mechanism 110 and a slave robotic arm 111 that is mounted on and extending from the passive mounting mechanism 110. Surgical instruments 112 and 113 may be removably coupled at the end of each slave robotic arm 111 of the first and second arm assemblies 105, 106. Each of the instruments 112, 113 may be coupled to a corresponding slave robotic arm 111 in a variety of fashions, for example, using a tool adapting mechanism 114. The tool adapting mechanism 114 may be a mechanical or specifically a servo-mechanical interface that may be configured for manipulating end effectors 115 and 116 of the surgical instruments 112 and 113. The tool adapting mechanism 114 may include a plurality of motion and electrical feed-throughs for articulating the instruments, and for sending electrical signals to and from the instrument, e.g., force and torque feedback signals, etc. The tool adapting mechanism 114 may be configured for coupling the distal end of the slave robotic arms 111 with the surgical instruments 112, 113 and transferring at least two DOFs from the arms 111 to the instruments 112 and 113.

According to some implementations, the surgical instrument 112 and 113 may be non-articulating laparoscopic instruments, handled wrist-articulating instruments, or handle-free wrist articulating instruments having at least two degrees of freedom of grasp, roll, pitch, and yaw.

The passive mounting mechanism 110 may be configured with three Degrees of Freedom (DOFs) and may be configured for aligning the fixed point of the slave robotic arms 111 with the incision location prior to the surgery. The slave robotic arms 111 may be configured with three active DOFs and one passive DOF and they may be configured to manipulate the instruments 112, 113.

Referring to FIGS. 1B-1D, it is to be understood that the tele-surgery system may have any number of arm assemblies. FIG. 1B shows an example implementation with two arm assemblies 105 and 117 slidably mounted on the track assembly 107 a on the side of the patient support assembly 104. In this exemplary configuration, the two arm assemblies 105 and 117 may be mounted on one side of the patient support assembly 104 and the other side may be left empty, for example, for an assistant to be able to take part in the surgery.

FIG. 1C shows an example implementation with three arm assemblies 105, 106, and 117 slidably mounted on the sliding tracks 107 a and 107 b on either sides of the patient support assembly 104. The additional arm assembly 106, may hold an additional instrument 118.

FIG. 1D shows an example implementation with four arm assemblies 105, 106, 117, and 119 slidably mounted on the sliding tracks 107 a and 107 b on either sides of the patient support assembly 104. In an implementation, one of the arm assemblies 105, 106, 117, or 119 may be configured with an endoscope or camera (not visible in FIGS. 1A-1D) that is attached to its slave robotic arm (not explicitly numbered in FIG. 1D) and that arm assembly may be called an endoscope/camera arm. However, it is to be appreciated that the configuration of the endoscope/camera arm, may be different as the purpose of the endoscope/camera arm is to hold and position an endoscope or camera as opposed to hold and position a surgical instrument.

Referring to FIG. 1A, the instruments 112 and 113 and the endoscope/camera 109 may be inserted through incisions cut into the skin of the patient 103. The endoscope/camera 109 may be coupled to a monitor 120 which displays images of the internal organs of the patient 103. The slave robotic arms 111 as well as the endoscope/camera assembly 108 may be coupled to a controller 121 which may control the movement of the arms 111 and the endoscope/camera assembly 108. The arms 111 may be coupled to the controller 121 via wiring, cabling, or via a transmitter/receiver system such that control signals may be passed from the controller 121 to each of the arms 111.

The controller 121 receives the input signals from master robotic arms 122 and moves the slave robotic arms 111 of the arm assemblies 105 and 106 in accordance with the input commands of a surgeon 123.

The movement and positioning of instruments 112, 113 attached to the slave robotic arms 111 of the first and second arm assemblies 105 and 106 may be controlled by the surgeon 123 at a pair of master handles 124 and 125. Each of the master handles 124, 125 which may be manipulated by the surgeon 123, has a master-slave relationship with a corresponding one of the slave robotic arms 111 so that movement of a handle 124 or 125 produces a corresponding movement of the surgical instrument 112, 113 attached to the slave robotic arms 111.

The master handles 124 and 125 that are a part of the master robotic arms 122 may be mounted to an ergonomic adjustment mechanism 126 of a surgeon console 127. A second monitor 128 may be mounted onto the surgeon console 127 and be configured to function as a user interface unit. The master handles 124 and 125 are also coupled to the controller 121. The controller 121 receives input signals from the master handles 124 and 125, computes a corresponding movement of the surgical instruments 112, 113, and provides output signals to move the slave robotic arms 111 and the instruments 112 and 113. The master robotic arms 122 may be configured to provide a plurality of DOFs to the arm assemblies 105 and 106 and corresponding surgical instruments 112 and 113, the DOFs may include pitch and yaw movements of the instruments 112 and 113, rotational and axial movements, and articulation of the end effectors 115 and 116 on the instruments 112 and 113.

The ergonomic adjustment mechanism 126 may be configured with three passive DOFs to allow for adjustment of the position and orientation of the master robotic arms 122 in order to enable the surgeon 123 to perform the surgery in an ergonomic comfortable posture, in either a sitting position or a standing position. A chair 129 may be provided for the sitting position. The ergonomic adjustment mechanism 126 will be described in detail later in the present disclosure.

The orientation of the patient 103 during surgery may be adjusted by the patient support assembly 104 and the fixed point of the slave robotic arms 111 may be aligned with the incision location utilizing the passive mounting mechanisms 110 that are mounted on the patient support assembly 104. Benefits of these features may include, but are not limited to, maintaining the alignment between the fixed point of the slave robotic arms 111 and the incision location during surgery, and enabling changes in the patient's orientation during surgery without the need for removing surgical instruments 112 and 113 from the patient's body. The patient 103 alignment may be desirable for certain surgeries to position internal organs by gravity effects.

Patient-Side Unit

FIG. 2A shows a perspective view of one example patient-side unit 200. FIG. 2B shows a perspective view of the patient-side unit 200 without protective covers. Referring to FIG. 2A, the patient-side unit 200 may include a patient support assembly 201, a passive mounting mechanism 202, a slave robotic arm 203, and a tool adapting mechanism 204 that is mounted on distal end of the slave robotic arm 203. The tool adapting mechanism 204 may be configured for coupling the distal end of the slave robotic arm 203 with a surgical instrument 247 having an end-effector 248 and transferring at least two DOFs from the arm 203 to the end-effector 248.

Referring to FIG. 2B, the patient support assembly 201, may be structured as a bed or a treatment table, configured to support a patient during surgery. The patient support assembly 201 may be configured with three DOFs (i.e., a linear DOF and two rotational DOFs). The linear DOF may include a substantially vertical axis 205 and the two rotational DOFs may include a roll axis 206 and a pitch axis 207. The aforementioned DOFs may allow for changing the height of the patient support assembly 201 and the orientation of the patient's body during surgery. The patient support assembly 202 may include a moving mechanism to effectuate translational movements of the patient support assembly 202 along axis 205 and rotational movements of the patient support assembly 202 about axes 206 and 207.

Referring to FIGS. 2B-2E, the passive mounting mechanism 202 may be configured to allow for mounting the slave robotic arm 203 on the side of the patient support assembly 201. The passive mounting mechanism 202 may include a first sliding segment 208, a second sliding segment 209, a third sliding segment 210, and a pan/tilt mounting mechanism 211. The first sliding segment 208 may be slidably mounted on the patient support assembly 201 and it may be configured to allow for a sliding movement of the passive mounting assembly 202 along a first linear axis 212 of the patient support assembly 201. The second sliding segment 209 may be slidably mounted on the first sliding segment 208 and it may be configured to allow for a sliding movement of the second sliding assembly 209 along a second linear axis 213. The third sliding segment 210 may be slidably mounted on the second sliding segment 209 and it may be configured to allow for a sliding movement of the third sliding assembly 210 along a third linear axis 214. The pan/tilt mounting mechanism 211 may be mounted on the third sliding segment 210 and it may be configured to allow for mounting the slave robotic arm 203 on the passive mounting mechanism 202.

Referring to FIGS. 2C-2E, the first sliding segment 208 may include a first wagon assembly 215 and a second wagon assembly 216. The first wagon assembly 215 may be configured to allow for slidably mounting the first sliding segment 208 on the patient support assembly 201 and the second wagon assembly 216 may be configured to allow for slidably mounting the second sliding segment 209 on the first sliding segment 208.

Referring to FIG. 2D, the first wagon assembly 215 may include first sliding wagons 217 that may be slidably mounted on a bed track assembly 218 that may be attached to the side of the patient support assembly 201. The bed track assembly 218, may include two parallel rails 219. The first sliding wagons 217 may be slidably mounted on the two parallel rails 219 and may be slidably movable on the two parallel rails 219 along the first linear axis 212 (visible and numbered in FIGS. 2B and 2C).

Referring to FIGS. 2C-2E, the second sliding segment 209 may include a first track assembly 220, and a third wagon assembly 221. The second sliding segment 209 is mounted on the first sliding segment 208 via the second wagon assembly 216 of the first sliding segment 208. Referring to FIGS. 2D and 2G, the second wagon assembly 216 may include second sliding wagons 222 that may be slidably coupled with the first track assembly 220 of the second sliding segment 209 and the second sliding wagons 222 may be slidably movable on the first track assembly 220 along the second linear axis 213.

Referring to FIGS. 2C-2E, the third sliding segment 210 may include a second track assembly 223. The second track assembly 223 may be slidably coupled with the third wagon assembly 221 of the second sliding segment 209 and it may be configured to allow for a sliding movement of the third sliding segment 210 relative to the second sliding segment 209 along the third linear axis 214.

Referring to FIGS. 2C-2F, the pan/tilt mounting mechanism 211 may be mounted on the third sliding segment 210 via a first attachment member 224. Referring to FIG. 2F, the pan/tilt mechanism 211 may include: a bearing unit 225 housed in the first attachment member 224; a shaft assembly 226; and an arm attachment interface 227. Lower end 228 of the shaft assembly 226 may be coupled with the bearing unit 225. The bearing unit 225 may be configured to facilitate a pan rotational movement of the pan/tilt mounting mechanism 211 about a pan axis 229. Two upper ends 230 of the shaft assembly 235 may be coupled with the arm attachment interface 227 via two tilt bearing units 231 attached to either sides of the arm attachment interface 227 that are configured to facilitate a tilt rotational movement of the pan/tilt mounting mechanism 211 about a tilt axis 232. Referring to FIGS. 2A and 2F, the slave robotic arm 203 may be mounted on the passive mounting mechanism 202 via the arm attachment interface 227. The pan/tilt mounting mechanism 211 may be configured to allow for rotational movements of the slave robotic arm 203 about the pan axis 229 and the tilt axis 232.

Referring to FIGS. 2B and 2F, the five DOFs (i.e., three translational DOFs along axes 212, 213, 214, and two pan and tilt DOFs about axes 229 and 232) of the passive mounting mechanism 202 may be locked in position before surgery. Referring to FIGS. 2C-2E, the first wagon assembly 215 may include two locks 233 and 234 that may be configured for locking the first sliding wagons 217 in position. Referring to FIG. 2G, the second wagon assembly 216 may include two locks 235 and 236 that may be configured for locking the second sliding wagons 222 in position. Referring to FIG. 2E, the third wagon assembly 221 may include two locks 237 and 238 that may be configured for locking sliding wagons 239 of the third wagon assembly 221 in position.

Referring to FIGS. 2C and 2G, the first sliding segment 208 may further include a first counter weight mechanism 240 that may be configured to facilitate the translational movement of the second sliding member 209 along the axis 213. The first counter weight mechanism 240 may be configured to compensate for the weight of the second sliding segment 209, third sliding segment 210, pan/tilt mounting mechanism 211, and the slave robotic arm 203 and as a result, it may facilitate manual lifting of the second sliding segment 209 along axis 213. The first counter weight mechanism 240 may include, for example a first constant-force spring 241.

Referring to FIGS. 2H and 2I, the second sliding segment 209 may further include a second support structure 242 that may be configured for supporting various electronic parts, for example, controller components 243, which form a part of the controller. The third sliding segment 210 may further include a third support structure 244 that may be configured for supporting various electronic parts, for example, motor drivers 245.

FIG. 3A shows an assembled view of one example of a slave robotic arm 203. FIG. 3B shows an exploded view of the slave robotic arm. FIG. 3C shows an exploded left view of the slave robotic arm.

Referring to FIG. 3A, the slave robotic arm 203 may include a first actuating mechanism 301, a first arm segment 302, a second actuating mechanism 303, a second arm segment 304, a passive actuating mechanism 305, an active actuating mechanism 306, and a tool attachment interface 307.

Referring to FIGS. 3A-3C, the first actuating mechanism 301 may be configured for driving a roll rotation of the first arm segment 302 about a first rotational axis 308. The first actuating mechanism 301 may include a first motor 309 coupled with a base end of the first arm segment 302 via a first gear box 310. The first motor 309 and the first gear box 310 may be configured to drive the roll rotation of the first arm segment 302 about the first rotational axis 308. The first gear box 310 may be, for example, a harmonic drive gear box.

Referring to FIGS. 3A-3C, the second actuating mechanism 303 may be mounted on a distal end of the first arm segment 302 and may be configured for driving a rotational movement of the second arm segment 304 about a second rotational axis 311. The second actuating mechanism 303 may include a second motor 312 and a second gearbox 313. The second motor 312 may be coupled with a proximal end of the second arm segment 304 via the second gear box 313. The second motor 312 and the second gear box 313 may be configured to drive a rotational movement of the second arm segment 304 about the second rotational axis 311.

Referring to FIGS. 3A-3C, the passive actuating mechanism 305 may include a passive track 314, a passive wagon 315, and a passive locking mechanism 316. The passive wagon 315 may be attached to the distal end of the second arm segment 304 and it may be configured to facilitate a sliding movement of the passive track 314 along a translational axis 317. The passive actuating mechanism 305 may be actuated by hand and it may be utilized to facilitate changing the instrument 326 by raising the tool adapting mechanism 204. The height of the instrument 326 may also be adjusted utilizing the passive actuating mechanism 305.

Referring to FIG. 3A-3C, the active actuating mechanism 306 may include a linear actuating mechanism 318, a moving wagon 319 and an active track 320 that is attached to the passive track 314 of the passive actuating mechanism 305. The linear actuating mechanism 318 may include a motor 321 and a ball-screw mechanism 322. The linear actuating mechanism 318 may be mounted on the moving wagon 319 and the moving wagon 319 may be slidably mounted on the active track 320. The linear actuating mechanism 318 is configured to facilitate the linear translational movement of the moving wagon 319 on the active track 320 along the translational axis 317. A force sensor 323 may be mounted on the active actuating mechanism 306 from one side and to the tool attachment interface 307 from the other side. The force sensor 323 may be configured for sensing force/torque exerted on a laparoscopic instrument 326 that is attached via the tool attachment interface 307 to the active actuating mechanism 306 on the distal end of the slave robotic arm 203.

Referring to FIG. 3B, the tool adapting mechanism 204 may be attached to the distal end of the slave robotic arm 203 via the tool attachment interface 307. The tool adapting mechanism 204 may activate DOFs of a laparoscopic surgical instrument 326 to interact with a tissue under surgery. The second arm segment 304 may be attached to a sleeve holder 325 that may be configured for holding a sleeve 327 of the laparoscopic surgical instrument 326 for more stability.

Surgeon-Side Unit

FIG. 4A shows a perspective view of one example surgeon-side unit 400. Referring to FIG. 4A, the surgeon-side unit 400 may include an ergonomic adjustment mechanism 401, two master robotic arms 402, a display system 403, and a user interface unit 497. The ergonomic adjustment mechanism 401 may be configured for adjusting the position and orientation of the master robotic arms 402 using three DOFs.

Referring to FIGS. 4B and 4C, the ergonomic adjustment mechanism 401 may include a main frame 404, a vertical adjustment mechanism 405, and a horizontal adjustment mechanism 406. The vertical adjustment mechanism 405 may be mounted on the main frame 404 and it may include a sliding assembly 407, a vertical track assembly 408 and a locking mechanism 409 on either sides of the ergonomic adjustment mechanism 401. The sliding assembly 407 may include a plurality of sliding wagons 410 that may be slidably mounted on the vertical track assembly 408 and may be configured to facilitate the vertical translational movement of the sliding assembly 407 along a substantially vertical axis 411. The vertical track assembly 408 may include two parallel rails 412 configured to allow for a translational movement of the wagons 410 along the axis 411. The locking mechanism 409 may include a locking screw 413 and a vertically extended locking plate 414 having a plurality of stacked locking holes that allow for locking the sliding assembly 407 at different heights based on the preference of a user (i.e., a surgeon). The vertical track assembly 408 may further include a counter weight mechanism 416 that may include a plurality of constant-force spring mechanisms 417. The counter weight mechanism 416 may be configured to facilitate vertical movements of the sliding assembly 407. The sliding assembly 407 may further include a coupling member 418 that may be for example a bearing unit that may be configured to allow for mounting the horizontal adjustment mechanism 406 between the sliding assemblies 407 on either sides of the ergonomic adjustment mechanism 401.

The horizontal adjustment mechanism 406 may be rotatably mounted on the vertical adjustment mechanism via the coupling member 418 and it may include a main shaft 419, and two mounting platforms 420. The main shaft 419 may be coupled via the coupling members 418 with the sliding assemblies 407 of the vertical adjustment mechanism 405. The coupling members 418 may be configured to allow for a rotational movement of the shaft 419 about a rotational axis 421. A horizontal rail 422 may be attached to the main shaft 419 and a smaller rail 423 may be attached to the mounting platform 420 to form a horizontal track assembly 424 that may be configured for facilitating a horizontal movement of the master robotic arms 402 along a horizontal axis 425. Weight balance mechanisms 426 may be used to stabilize the mounting platforms 420 in position. The weight balance mechanisms 426 may include gas spring mechanisms. The three DOFs (i.e., two linear DOFs along axes 411, 425 and one linear DOF about axis 421) of the ergonomic adjustment mechanism 401 may be locked in position during surgery.

Referring to FIG. 4D, the master robotic arm 402 may include a master handle 427, a pitch sensing/actuating mechanism 428, a yaw sensing/actuating mechanism 429, a roll sensing/actuating mechanism 430, an insert sensing/actuating mechanism 431, a grasp sensing/actuating mechanism 432, and a finger-roll sensing/actuating mechanism 433.

Referring to FIG. 4G, the master handle 427 may be structured similar to a manual surgical instrument. The master handle 427 may be manipulated by hand of a user (i.e., surgeon) and it may include a scissor-type configuration having a movable handle 434, a stationary handle 435, and a roll-knob 436. Referring to FIG. 4F, the user may manipulate the tool handle 427 to make pitch and yaw rotational movements about a pitch axis 438 and a yaw axis 439. Each master handle 427 on each master robotic arm 402 may be associated with one slave robotic arm 203 and the tool adapting mechanism 204 attached thereto.

Referring to FIGS. 4D and 4E, the pitch sensing/actuating mechanism 428 may include: a pitch rotary actuator 440, for example, an electric motor; a pitch transmission mechanism 441; a pitch link arm 442 and a pitch gimbal 443. The pitch sensing/actuating mechanism 428 may be configured for both capturing the pitch position of the tool handle 427 and creating pitch force feedback to the tool handle for providing a haptic sensation. As used herein, “capturing the pitch position” may mean sensing the amount of rotational movement of the tool handle 427 about the pitch axis 438.

Referring to FIG. 4E, the pitch transmission mechanism 441 may include: a pitch cable transmission mechanism 444 having a spool 445 coupled with the pitch rotary actuator 440; a pitch rotary output member 446 that may be coupled with the spool 445 using a cable secured form one side to a first pitch cable connector 447 and form the other side to a second pitch cable connector 448, such that the torque from the pitch rotary actuator 440 may be transmitted via the cable to the pitch rotary output member 446. The pitch rotary output member 446 may be coupled with a pitch shaft 449 and the pitch shaft 449 may be held in place using a pitch bearing unit 450 and it may be coupled with the pitch link arm 442 via a pitch coupling member 451. The pitch coupling member 451 may define a joint which allows the pitch link arm 442 to articulate. The pitch link arm 442 may articulate bi-directionally, in response to corresponding rotation of the pitch shaft 449 about the pitch axis 438. The pitch link arm 442 may be attached to the pitch gimbal 443. The pitch gimbal 443 may be connected to a central rail 452 attached to the tool handle 427.

Referring to FIG. 4E, the yaw sensing/actuating mechanism 429 may include: a yaw rotary actuator 453, for example, an electric motor; a yaw transmission mechanism 453; a yaw link arm 455 and a yaw gimbal 456. The yaw sensing/actuating mechanism 429 may be configured for both capturing the yaw position of the tool handle 427 and creating yaw force feedback to the tool handle for providing a haptic sensation. As used herein, “capturing the yaw position” may mean sensing the amount of rotational movement of the tool handle 427 about the yaw axis 439.

The yaw transmission mechanism 454 may include: a yaw cable transmission mechanism 457 having a spool 458 coupled with the yaw rotary actuator 453; a yaw rotary output member 459 that may be coupled with the spool 458 using a cable secured form one side to a first yaw cable connector 460 and from the other side to a second yaw cable connector 461, such that the torque from the yaw rotary actuator 453 may be transmitted via the cable to the yaw rotary output member 459. The yaw rotary output member 459 may be coupled with a yaw shaft 462 and the yaw shaft 462 may be held in place using a yaw bearing unit 463 and it may be coupled with the yaw link arm 455 via a yaw coupling member 464. The yaw coupling member 464 may define a joint which allows the yaw link arm 455 to articulate. The yaw link arm 455 may articulate bi-directionally, in response to corresponding rotation of the yaw shaft 462 about the yaw axis 439. The yaw link arm 455 may be attached to the yaw gimbal 456. The yaw gimbal 456 may be connected to the central rail 452.

In an implementation, the pitch gimbal 443 and the yaw gimbal 456 may be mounted on one another with orthogonal pivot axes (i.e., pitch axis 438 and yaw axis 439) on the master handle 427. Any pitch-rotational movement made by the user may be picked up by the pitch gimbal 443 and it may be transmitted to the pitch rotary actuator 440 via the pitch link arm 442 and the pitch transmission mechanism 441. The pitch-rotational movement of the handle 427 may then be encoded and transmitted by the controller that is connected to the driver of the pitch rotary actuator 440 to the slave robotic arm for the pitch movement to be recreated by the slave robotic arm in the patient-side unit. Any yaw-rotational movement made by the user may be picked up by the yaw gimbal 456 and it may be transmitted to the yaw rotary actuator 453 via the yaw link arm 455 and the yaw transmission mechanism 454. The yaw-rotational movement of the handle 427 may then be encoded and transmitted by the controller that is connected to the driver of the yaw rotary actuator 453 to the slave robotic arm for the yaw movement to be recreated by the slave robotic arm in the patient-side unit.

Referring to FIG. 4E, the roll sensing/actuating mechanism 430 may include: a roll rotary actuator 465, for example, an electric motor; and a roll transmission mechanism 466. The roll sensing/actuating mechanism 430 may be configured for both capturing the roll position of the tool handle 427 and creating a roll force feedback to the tool handle 427 for providing a haptic sensation. As used herein, “capturing the roll position” may mean sensing the amount of rotational movement of the tool handle 427 about a roll axis 467.

The roll transmission mechanism 466 may include: a roll cable transmission mechanism having a spool 469 coupled with the roll rotary actuator 465; and a yaw rotary output member 470 that may be coupled with the spool 469 using a cable. The roll rotary output member 470 may be connected to the central rail 452. The roll transmission mechanism 466 may be configured to transmit the roll-rotation of the roll rotary actuator 465 to the central rail 452 and it may be configured to pick up any roll-rotation movements made by the surgeon on the master handle 427. The roll-rotational movement of the handle 427 may then be encoded and transmitted by the controller that is connected to the driver of the roll rotary actuator 464 to the slave robotic arm for the yaw movement to be recreated by the slave robotic arm in the patient-side unit.

Referring to FIG. 4F, the insert sensing/actuating mechanism 431 may include: an insert rotary actuator 471, for example, an electric motor; and an insert transmission mechanism 472. The insert sensing/actuating mechanism 431 may be configured for both capturing the insert position (i.e., position of the surgical tool along its longitudinal axis) of the tool handle 427 and creating an insert force feedback to the tool handle 427 for providing a haptic sensation. As used herein, “capturing the insert position” may mean sensing the amount of translational movement of the tool handle 427 along a tool handle longitudinal axis 473.

The insert transmission mechanism 472 may include an insert wagon 474 that may be mounted on the yaw gimbal 456. The insert wagon 474 may be slidably mounted on the central rail 452 and it may be configured for facilitating a translational sliding movement of the central rail 452 along the longitudinal axis 473 of the master handle 427. A spool 475 may be coupled with the insert rotary actuator 471 and it may be secured on a cable connecting member 476 at a distal end of the central rail 452. The cable moves the central rail 452 in a translational movement along the longitudinal axis 473 of the tool handle 427 upon actuation. The position of the tool handle 427 along the longitudinal axis (i.e., insert position) may be picked up by the central rail 452 and it may be transmitted through the cable to the insert rotary actuator 471. The insert position of the handle 427 may then be encoded and transmitted by the controller that is connected to the driver of the insert rotary actuator 471 to the slave robotic arm for the insert movement to be recreated by the slave robotic arm in the patient-side unit.

Referring to FIG. 4G, the finger-roll sensing/actuating mechanism 433 may include: a finger-roll rotary actuator 477, for example, an electric motor coupled with the roll knob of the tool handle. The finger-roll sensing/actuating mechanism 433 may be configured for both capturing the finger-roll position of the roll-knob 436 on the tool handle 427 and creating a force feedback to the roll-knob 436 of the tool handle 427 for providing a haptic sensation. As used herein, “capturing the finger-roll position” may mean sensing the amount of rotational movement of the roll-knob 436 on the tool handle 427. The finger-roll transmission mechanism 433 may be configured to transmit the roll-rotation of the finger-roll rotary actuator 477 to the roll-knob 436 and it may be configured to pick up any roll-rotation movements made by the surgeon on the roll-knob 436. The roll-rotational movement of the roll-knob 436 may then be encoded and transmitted by the controller that is connected to the driver of the finger-roll rotary actuator 464 to the slave robotic arm for the roll-knob movement to be recreated by the slave robotic arm in the patient-side unit. Referring to FIGS. 4G and 2B, the roll-rotational movement of the roll-knob 436 may drive a local roll-rotation of the end-effector 248 of the surgical instrument 247 about a local roll axis parallel to a longitudinal axis of the end-effector.

Referring to FIG. 4G, the grasp sensing/actuating mechanism 432 may include: a grasp rotary actuator 478, for example, an electric motor; and a grasp transmission mechanism 479. The grasp sensing/actuating mechanism 432 may be configured for both capturing the grasp position of the movable handle 434 and creating a grasp force feedback to the movable handle 434 for providing a haptic sensation. As used herein, “capturing the grasp position” may mean sensing the amount of rotational movement of the movable handle 434 about a pivot point 480 in the direction shown by an arrow 481.

The grasp transmission mechanism 479 may include: a grasp cable transmission mechanism 482 having a spool 483 coupled with the grasp rotary actuator 478; and a grasp output member 484 that may be coupled with the spool 483 using a cable secured on one side to a first grasp cable connecting member 485 and on the other side to a second grasp cable connecting member 486. The grasp output member 484 may be connected to the movable handle 434. The grasp transmission mechanism 479 may be configured to transmit the rotation of the grasp rotary actuator 478 to the movable handle 434 and it may be configured to pick up any grasp movements made by the surgeon on the movable handle 434. The grasp movement of the movable handle 434 may then be encoded and transmitted by the controller that is connected to the driver of the grasp rotary actuator 478 to the slave robotic arm for the grasp movement to be recreated by the slave robotic arm in the patient-side unit.

Referring to FIGS. 4E and 4G, the master handle 427 may further comprise a force sensor 489 that may be configured to measure force/torque exerted on the master handle 427. The force sensor 489 may be utilized to make sure the same amount of force/torque feedback is being recreated by the actuating mechanisms 428-433 in the surgeon side-unit 400 as is exerted on the surgical tool in the patient-side unit.

Referring to FIG. 4D, the master robotic arm 402 may further include a mounting assembly 490 that may include a support structure 491, a sliding mechanism 492, and a locking mechanism 493. The support structure 491 may be configured to provide a platform for mounting of various components of the master robotic arm 402. The sliding mechanism 492 may include a plurality of sliding wagons 494 that may be slidably mounted on the horizontal track assembly 424 to facilitate a translational movement of the master robotic arm 402 along the horizontal axis 425. The locking mechanism 493 may include a locking screw 495 that may be configured to allow for locking the sliding wagons 494 in desired positions on the horizontal sliding track 424.

Referring to FIG. 4A, the surgeon-side unit 400 may further include input means 496 for controlling a camera inserted in the patient's body and for applying cauterizing current to the surgical tool attached on the distal end of the slave robotic arm.

FIG. 5, illustrates an exemplary scenario for aligning a fixed point (i.e., remote center of motion) of the robotic arms with the incision location on patient's body utilizing the passive mounting mechanism, consistent with exemplary embodiments of the present disclosure. First, based on the type of surgery and the target organ, the incision points on the patient's body are determined by the surgeon. Sometimes an optimizing program (not in the scope of the present disclosure) may be used in order to optimize the incision locations. The optimizing program, optimizes the incision locations for better maneuverability of the robotic arms. The incision is made in the determined incision location. The surgical instrument is placed inside the incision.

Before the surgery, the surgeon determines the pan and tilt angles of the slave robotic arm 203 based on the type of surgery and the target organ. The pan and tilt DOFs can be adjusted utilizing the pan/tilt mounting mechanism 211. Pan and tilt are passive DOFs and once they are adjusted by the surgeon before surgery, they will be locked during the surgery.

Referring to FIG. 5, once the incision is made in the pre-determined incision location 501, the surgical instrument 326 that is secured inside a holding member 502 on the distal end of the sleeve holder 325, will be inserted inside the incision. Then, the surgeon must adjust the position of the slave robotic arm 203 such that the proximal end of the sleeve holder 325 can be clamped on an attachment member 504 on the second arm segment 304. Utilizing the three DOFs 212, 213, and 214 of the passive mounting mechanism 110 the surgeon is able to place the attachment member 504 inside a clamping member 503 on the proximal end of the sleeve holder 325 and clamp the sleeve holder 325 to the slave robotic arm 203.

While the foregoing has described what are considered to be the exemplary embodiments, it is understood that various modifications may be made therein and that the subject matter disclosed herein may be implemented in various forms and examples, and that the teachings may be applied in numerous applications, only some of which have been described herein. It is intended by the following claims to claim any and all applications, modifications and variations that fall within the true scope of exemplary embodiments consistent with the present disclosure.

It will be understood that the terms and expressions used herein have the ordinary meaning as is accorded to such terms and expressions with respect to their corresponding respective areas of inquiry and study except where specific meanings have otherwise been set forth herein. Relational terms such as first and second and the like may be used solely to distinguish one entity or action from another without necessarily requiring or implying any actual such relationship or order between such entities or actions. The terms “comprises,” “comprising,” or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. An element proceeded by “a” or “an” does not, without further constraints, preclude the existence of additional identical elements in the process, method, article, or apparatus that comprises the element. 

1-12. (canceled)
 13. A robotic tele-surgery system, comprising: a patient-side unit, including: a patient support assembly, movable in three degrees of freedom; at least two passive mounting mechanisms, each having five degrees of freedom, each slidably coupled to the patient support assembly allowing the passive mounting mechanisms to be moved along an axis parallel to an upper surface of the patient support assembly; and at least two slave robotic arms, each having three degrees of freedom, wherein the degrees of freedom of the surgical instrument include at least two members of a group consisting of grasp, roll, pitch, and yaw; a surgeon-side unit, including at least two master robotic arms, each having six degrees of freedom; a controller configured to establish a master-slave relationship between the patient-side unit and the surgeon-side unit, wherein movement at each master handle produces a proportional movement in a corresponding slave robotic arm.
 14. The system according to claim 13, wherein the surgeon-side unite further comprises an ergonomic adjustment mechanism movable in three degrees of freedom, the ergonomic adjustment mechanism configured to house and adjust position and orientation of the master robotic arms.
 15. A robotic tele-surgery system, comprising: a patient-side unit including: a patient support assembly movable in three degrees of freedom; at least two passive mounting mechanisms, each passive mounting mechanism including five degrees of freedom comprising a first linear axis, a second linear axis, a third linear axis, a pan axis, and a tilt axis, each passive mounting mechanism, comprising two or more of: a first sliding segment, slidably coupled to the patient support assembly configured to allow the passive mounting mechanism to be moved along the first linear axis parallel to the upper surface of the patient support assembly; a second sliding segment, slidably coupled to the first sliding segment, movable along the second linear axis; a third sliding segment, slidably coupled to the second sliding segment, movable along the third linear axis; and a pan/tilt mounting mechanism, configured to be attached to the base end of the slave robotic arm and to facilitate movement of the slave robotic arm about the pan axis and about the tilt axis, the pan/tilt mounting mechanism attached to the third sliding segment, wherein, the first, second, and third linear axes are mutually perpendicular, at least two slave robotic arms, each having three degrees of freedom, each comprising a base end and a distal end, the distal end configured to be coupled with a conventional surgical instrument; and a surgeon-side unit including at least two master robotic arms, each having six degrees of freedom.
 16. The system according to claim 15, wherein the surgeon-side unite further comprises an ergonomic adjustment mechanism movable in three degrees of freedom, the ergonomic adjustment mechanism configured to house and adjust position and orientation of the master robotic arms.
 17. A robotic tele-surgery system. comprising: a patient-side unit including: a patient support assembly, movable in three degrees of freedom; at least two passive mounting mechanisms, each having five degrees of freedom, each slidably coupled to the patient support assembly allowing the passive mounting mechanisms to be moved along an axis parallel to an upper surface of the patient support assembly; at least two slave robotic arms, each having three degrees of freedom, each of the two slave robotic arms configured to be coupled with a surgical instrument, wherein the surgical instrument is one of non-articulating laparoscopic instruments, handled wrist-articulating instruments, and handle-free wrist articulating instruments; a surgeon-side unit including at least two master robotic arms, each having six degrees of freedom; and a controller configured to establish a master-slave relationship between the patient-side unit and the surgeon-side unit, wherein movement at each master handle produces a proportional movement in a corresponding slave robotic arm.
 18. The system according to claim 17, wherein the surgeon-side unite further comprises an ergonomic adjustment mechanism movable in three degrees of freedom, the ergonomic adjustment mechanism configured to house and adjust position and orientation of the master robotic arms. 